Case study hypertension and diabetes
Kidney Int. A year-old African American woman presents for her annual physical exam.
After starting the new BP medication, she should monitor BP at home and return to the clinic in 1 month.
The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy.
Renal case studies for medical students
The treatment of choice for hypertensive diabetic patients with or without microalbuminuria remains angiotensin-converting enzyme ACE inhibitors. J Hyperten 16 Suppl 1 :S, A year-old African American woman presents for her annual physical exam. There are no obvious clues for another cause of the kidney disease, for example, symptoms from vasculitis or lupus, a history of chronic infections or exposure to nephrotoxic drugs, although additional laboratory evaluation may be needed to exclude less apparent causes. Type 1 diabetic patients should be screened 5 years after diagnosis of diabetes and after puberty. Transient elevations in urinary albumin excretion may be associated with marked hyperglycemia, acute febrile illness, exercise, hypertension, heart failure, and urinary tract infection. The lack of signs and symptoms of arterial disease and a renal ultrasound showing symmetric, normal-sized kidneys are reassuring. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and combined therapy in patients with micro- and macroalbuminuria and other cardiovascular risk factors: a systematic review of randomized controlled trials. Finally, the patient should attempt to develop coping skills for specific stressors at work and home. With a presumptive diagnosis of diabetic kidney disease, a kidney biopsy is usually not performed.
N Engl J Med. What treatment strategy should be used? Microscopic examination of the urine sediment shows no cells, casts or crystals.
If clinically appropriate, she should also avoid agents which could elevate BP, such as NSAIDs, oral steroids, stimulants, and decongestants. Only captopril Capoten is approved for the treatment of diabetic nephropathy, but all ACE inhibitors appear to be effective.
Hypertension case study
If clinically appropriate, she should also avoid agents which could elevate BP, such as NSAIDs, oral steroids, stimulants, and decongestants. He has decreased vibratory sensation in his lower extremities and trace bilateral lower leg edema. Ann Intern Med. After starting the new BP medication, she should monitor BP at home and return to the clinic in 1 month. Clinical Pearls Screen diabetic patients for microalbuminuria. He also has albuminuria. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Accessed December 15, A year-old African American woman presents for her annual physical exam. Laboratory tests should include an HbA1c, lipid panel and urine protein to creatinine ratio. See Also. Patient-specific factors, such as age, comorbidities, concurrent medications, drug adherence, and out-of-pocket costs should be considered. A year-old man presents after a recent ophthalmic exam that showed diabetic retinopathy.
based on 74 review